What S.F. can learn from Salt Lake City

The lack of homeless people in the park surrounding City Hall in Salt Lake City is an indicator of progress made in efforts to get people into housing.
Brant Ward / The Chronicle

SALT LAKE CITY — This city has all but ended chronic homelessness, and San Francisco could learn a lot from how that happened.

What Salt Lake City did was simple: It created attractive housing that street people actually longed to live in, provided the new residents with plenty of on-site counseling to help them with problems such as drug abuse and unemployment, and put one person in charge who could get government and nonprofit agencies to work together.

The result is that in the decade since Salt Lake and San Francisco launched campaigns to end chronic homelessness, Salt Lake’s hard-core street population shrank so drastically it is expected to be statistically gone by next year — but San Francisco still struggles mightily. And Salt Lake did this by spending $20 million a year in a million-resident metropolitan area. San Francisco spends $165 million.

San Francisco has challenges Salt Lake City doesn’t — real estate prices and the cost of living are more than twice as high in the Bay Area, and far more homeless people move to San Francisco than head to Salt Lake. And that $20 million in Salt Lake is bolstered by more than $20 million in additional donations from the Mormon Church and other nonprofit groups.

But even with its hurdles, San Francisco could have achieved more had it closely followed the Salt Lake model.

When Salt Lake and San Francisco began their 10-year plans to end chronic homelessness in 2005 and 2004, respectively, each had about 3,000 people who lived full time on their streets. Today, San Francisco has about 2,000 — and Salt Lake has about 400.

“What we’ve done is doable everywhere,” said Lloyd Pendleton, who as director of Utah’s homeless initiatives has been the main drum-pounder for getting things done. “It’s not rocket science. Homeless people need housing. Give it to them. And give them counseling.”

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A large walkway around the Salt Lake City public library is clean and free of graffiti.Brant Ward / The Chronicle

‘Why is it so clean?’

The evidence of Salt Lake’s success is easy to see — because there’s almost nothing to see.

Look around downtown, from the Mormon Temple to the Old West City Hall, and panhandlers and homeless camps are virtually nonexistent. For anyone used to being hit up for spare change every block or two in downtown San Francisco, it’s a startling contrast.

“There are no homeless people here — nowhere that I can see,” said Otie Malenz, a 29-year-old drifter from Chico who had just gotten to town and was napping on the City Hall lawn. “I heard years ago there were lots of homeless guys around — but now? Why is it so clean?

“It’s kind of freaky.”

The key to this camp-free cleanliness, local leaders say, is Salt Lake’s “housing first” program — an emphasis on putting chronically homeless people into supportive housing right after they accept it, especially if they are addicted or mentally ill.

Such housing is staffed by counselors who try to help the new residents get off drugs and find jobs, and who diagnose mental issues and deal with the other problems that can toss people into the streets long- term.

Through its aggressive housing practices, Salt Lake has brought its chronic homeless numbers down to nearly 4 percent of its overall homeless population — which, as with unemployment figures, is considered a statistical zero.

San Francisco’s chronic population, in contrast, amounts to 31 percent of the total.

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Grace Mary Manor is emblematic of the appealing living spaces Salt Lake City provides as part of its supportive housing.Brant Ward / The Chronicle

Wrong neighborhood

San Francisco has the same housing first policy as Salt Lake — but there’s a big difference. Many of the 5,000 units of supportive housing in San Francisco, though generally decent and clean, are in the seedy Tenderloin, where the newly housed walk out to find the same buddies they always hung out with to score dope and drink.

Rats and roaches, though less prevalent than in residential hotels that aren’t overseen by the city, are a problem — and provide a disincentive for many people to settle in.

By contrast, most of Salt Lake’s approximately 1,000 supportive housing units are in complexes away from the city core, and they are showpieces of modern architecture. Each is finely landscaped, the sidewalks are quiet and tidy, and the interiors are tasteful and inviting.

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A man naps on an upper floor of the Salt Lake City library, a popular place for the homeless.Brant Ward / The Chronicle

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Nils Abramson, one of several case managers at the Sunrise Metro supportive housing complex in Salt Lake City, walks down a well-maintained hallway to visit a resident.Brant Ward / The Chronicle

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At the Road Home shelter in Salt Lake City, Red Elk (center) settles in for the night with other homeless men.Brant Ward / The Chronicle

At Grace Mary Manor, built from the ground up in 2008, each of the 84 one-bedroom units comes with a full kitchen, pine furniture, a big reclining chair and a television. The hallways have skylights, there are pink roses and locust trees out front, and in back are basketball and volleyball courts. In the Bay Area, it would fit nicely into a neighborhood of midlevel condominiums.

“I’ve had my moments, but these guys pulled me through,” said Bill Alkire, 54, a recovering alcoholic who moved in four years ago after a decade on the streets. “My wife died in 2000 and I crawled into a bottle, and didn’t look back until I got to this place.”

His first years inside were pocked by episodes of drunkenness, crashing around the hallways and stumbling back onto the streets to wander. But with persistent counseling, he managed to shed his street-toughened ways.

There is one case manager for every 15 residents at Grace Mary, plus a half dozen other counselors to help with housing and therapy. In San Francisco, the figure at its best supportive-housing complexes is typically one case manager for every 30 residents — and about a third of its complexes have just one per 100 residents.

Case managers in San Francisco also often double as housing managers, leading to tension in the relationships when rent hassles arise.

“You’re looking great, Bill,” Grace Mary’s lead case manager, Kay Luther, said one recent afternoon as she popped her head into his one-bedroom apartment.

She does this once a week — in San Francisco, some supportive-housing residents might see a lead case manager once a month.

“No complaints today,” Alkire said as he leaned back in his overstuffed leather lounger. Several puzzles were framed on the wall; it’s his chief hobby these days instead of hoisting a bottle.

Luther went over some details of his application for federal disability payments, admired how clean he’s kept his apartment and then headed for the door.

“I’d be dead if not for you,” Alkire told her.

Helping the hard core

Alkire eventually stabilized, he and Luther said, partly because Grace Mary Manor is in the south end of town, away from where he used to hang out with his downtown drinking pals.

For that scene, he’d have to go to a three-block stretch of parks and streets, southwest of downtown, which holds the city’s shelter, soup kitchen and daytime respite center for the homeless.

There, seemingly every one of the city’s 400 remaining chronically homeless people hangs out. The street population looks much like the hard-core crowd in San Francisco — scruffy, with many smoking or shooting up every major drug from heroin to methamphetamine.

Some 700 people — counting both singles and families — sleep in the shelter every night. There they get intensive help from more than two dozen mental health, employment and other counselors, and most move on to permanent housing within two months.

San Francisco’s effort in the shelters isn’t nearly as intensive — there are fewer than a half dozen case managers at the biggest of its 12 facilities, which holds about 340 beds.

In Salt Lake, “the idea is, we don’t want people to just live in this shelter,” said Matt Minkevitch, executive director of the Road Home, which as the main nonprofit homelessness agency in Utah, runs the shelter. “We want to make it as comfortable as possible, but we want them to move on to housing — on to better lives.”

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Tonya Casablanca sits in her room at Palmer Court in Salt Lake City; she had been chronically homeless.Brant Ward / The Chronicle

Expert advice

San Francisco has had success with its housing-first strategy, moving more than 9,000 people off the streets in the past decade. But the chronic population has been stubbornly resistant to sharp reductions. It was 3,000 a decade ago, it’s about 2,000 now, and to many people it looks as if nothing on the streets has changed.

But San Francisco could make inroads by more closely following Salt Lake’s example. In fact, the Utah city got many of its ideas from one of San Francisco’s foremost experts.

“You want the chronically homeless person to walk into the supportive housing and say, ‘Wow, I really want to stay here,’.” said Dr. Josh Bamberger, a UCSF professor who until March was the medical director of housing and urban health for the city’s health department.

In 2012-13, when he was advising President Obama on homeless policies, Bamberger helped push the techniques that have enabled not just Salt Lake City, but also Denver, Minneapolis and other cities to make striking progress on reducing chronic homelessness, particularly among veterans — techniques Salt Lake was already deep into implementing.

The common denominator, he said, is creating better housing, making sure there’s enough counseling and getting all parties to cooperate.

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Homeless children, including Alexandra (center), peer through the fence enclosing their recreation area at a Salt Lake City shelter.Brant Ward / The Chronicle

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Lielandra Madori (left) sits with her newborn and other homeless people outside the Road Home in Salt Lake City shelter while waiting to be admitted.Brant Ward / The Chronicle

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Bonnie Harday, a homeless woman, hugs her son outside the Road Home shelter near downtown Salt Lake City.Brant Ward / The Chronicle

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At Palmer Court in Salt Lake City, one of the supportive housing facilities, formerly homeless residents enjoy a barbecue.Brant Ward / The Chronicle

“You want to create an environment where your peers living in the same supportive housing want to succeed, and that makes you want to succeed,” Bamberger said. “We can do that more here (in San Francisco), but we need to redirect our resources to make a better investment in a housing expansion.”

Supportive housing “doesn’t have to be new — it can be beautiful and renovated,” Bamberger said. “But put the highest-end users in it, more than we do now. Make the best use of what we have.”

The goal is to heal people enough so they can move on to productive lives, leaving their supportive housing units to be filled by new residents. In Salt Lake, about 15 percent of the population turns over every year, but in San Francisco that figure is under 5 percent.

Using services

By highest-end users, Bamberger means the hardest of the hard-core homeless, who use far more emergency services, such as ambulance rides, than other homeless people. To figure out which ones those are, Salt Lake City uses a data tracking system that shows every time a homeless person gets shelter, counseling or other services from a government or nonprofit agency. Then counselors can tailor housing and services to the person’s needs.

This also makes it much easier for government and nonprofits to quickly coordinate their efforts. San Francisco doesn’t have such a system. Its service providers have wanted one for a decade — and this summer, they plan to participate in a pilot project for just such a data-tracking system, led by the Human Services Agency and other city departments involved in aiding the homeless.

In the long run, targeting high-end users saves money. In 2004, the city estimated that each chronically homeless person costs taxpayers $61,000 a year, compared with the $16,000 it costs to put one person into supportive housing.

Trent Rhorer, who runs the Human Services Agency, and Bevan Dufty, the mayor’s chief of homelessness policy, concede that Salt Lake’s bounty of case managers and high-quality supportive housing are just what San Francisco needs. The trouble, they say, is funding. “Exits like that are harder here than in Salt Lake,” Rhorer said. “Where are they going to exit to in this high-cost market? We need more federal housing subsidies, and we need to leverage our public housing more than we do.”

Dufty said: “Look, we’re going to spend the money one way or another — either through expensive jail, shelter, emergency calls and so forth, or by investing in housing. It’s so clear what the best way to spend it is. With housing you not only give people better lives, you save money in the long run.”

Plywood mattress

Some of San Francisco’s homeless housing complexes are national showpieces along the lines of what is in Salt Lake. But too often, they aren’t. And too often, the route into them is discouraging.

Robin Wilden, 62, has been homeless for most of the past decade and uses a wheelchair because a bicycle accident six years ago left one leg several inches shorter than the other. She was placed into temporary housing this year at the Baldwin House residential hotel on gritty Sixth Street — which outreach counselors use as transitional residence for the chronically homeless, some of whom live there for as long as a year. But she rarely stayed at it because the bed she was given was a sheet of plywood and roaches crawled on her legs.

Now she sleeps on Market Street near Van Ness Avenue and drowns her misery by day with vodka.

“Is this how San Francisco helps the homeless — putting us in a trash can?” she said, sobbing. “That place was so depressing. Why would I want to stay in it?”

Such housing doesn’t appear to exist in Salt Lake, even as transitional units.

“We don’t do rats and roaches here,” Pendleton said. “We only do first-rate housing where you can move inside, and then actually feel like you want to move forward in your life.”

Pendleton said one factor to keep in mind is that “90 percent of chronically homeless people grew up disadvantaged from the start, in abusive or underprivileged homes.”

“You are not rehabilitating them,” he said, “because so many of them were never habilitated to begin with. You are creating new lives for them.”

Thus the emphasis on targeting the hardest of the hard- core for housing.

Leading the way

Such a task requires everyone involved — businesses, nonprofit agencies, government — to march in the same direction, led by a dynamic leader, Pendleton said. In Salt Lake and the rest of Utah, he is that leader.

Pendleton had been a director of the Mormon Church’s international charity programs before wading into the state’s street problem. When he retired from the church in 2005 to lead Utah’s homeless efforts, he was familiar with every nonprofit, private and governmental agency that counted — and had years of accumulated authority to give him heft.

San Francisco had such a leader in ex-Mayor Gavin Newsom when he backed the city’s 10-year plan and other initiatives. But since he left in 2010 to become lieutenant governor, many observers say, another leader on that scale has not emerged.

Salt Lake also benefits from the Mormon connection — the church contributes several million dollars in effort and donations on top of the $20 million the city spends on the homeless each year, Pendleton estimates.

There is no equivalent in San Francisco, but Pendleton and Bamberger say there’s one potential source that has not been tapped nearly as much as it should be: the cash-rich tech industry.

“If I was there, I would say to the tech industry leaders, ‘The money is important, but why don’t you loan us one of your brightest executives for a couple of years to help us organize a system to bring together the city, the state, the nonprofits — everyone?’.” Pendleton said. “You need a champion.”